Job title: Claims Specialist II
Job type: Temporary
Emp type: Full-time
Industry: Insurance
Functional Expertise: Administrative Call Centre
Location: Canada
Job published: 2023-10-03
Job ID: 60985

Job Description

Our client is a top financial institution with significant North American holdings. They have operations across most major verticals, including institutional & corporate, wealth management, private client, commercial banking, treasury, and retail banking.

Position Overview

Responsible for mitigating financial, legal and reputational Travel Claims Risks.

 

What you will achieve in this role:


• Work with Manulife’s Third Party Providers of emergency medical assistance who are seeking direction and advice on an active case.

• Work with Manulife’s Third Party Providers of claims seeking direction, advice or policy interpretation.

• Make final claims decisions, claims exceptions, and business decisions on contested and contentious claims.

• Review and respond to appeals or correspondence submitted by lawyers on behalf of their clients.

• Investigate, resolve, and respond to Escalated Complaints submitted to, but not  limited to the President’s Office, the Ombud Liaison Office, Senior Management, Social Media and Insurance Regulators

• Handle Travel litigated claims including corresponding with internal and external legal counsel, make recommendations on legal strategies and settlement offers, and represent Manulife at legal proceedings (including mediations, arbitrations, examinations for discovery, trials).

• Conduct random and/ or focused audits of travel claims (medical, out-of-country medical, visitor-to-Canada, trip cancellation/ interruption, baggage, accidental death and dismemberments) and credit card benefits (collision damage, personal effects, extended warranty) processed by Manulife’s Third Party Providers

• Assist in annual on-site audits of Manulife’s Third Party Providers of claims and assistance and perform follow-ups to ensure appropriate responses and action plans are implemented.

• Provide input on contract wording for new and existing products and plans.

 

What you will bring to this role:

•  University degree in any discipline or equivalent work experience.

• 3-5 years’ experience in adjudicating claims, preferably life, health or travel.

• Knowledge of medical terminology, medications and their applications, diseases, tests, and treatment modes is an asset.

• Proven analytical, problem solving, decision making, and negotiation skills.

• Evaluate alternatives and assess risks in making timely and effective decisions.

• Exceptional interpersonal skills with a high level of professionalism enabling to build strong relationships and to collaborate effectively.

• Ability to identify potential problems and risks, and be accountable for solutions.

• Exceptional customer service skills with the ability to respond under high pressure or difficult/ sensitive situations

• Strong organizational skills with the ability to effectively prioritize competing tasks

 

We thank you for your interest in the position, however, only those who are qualified will be contacted.

  

Inclusion and Equal Opportunity Employment

Our client is an equal opportunity employer committed to diversity and inclusion; creating an inclusive environment where all team members and clients feel like they belong.  We are pleased to consider all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, Aboriginal/Native American status or any other legally-protected factors.  We seek applicants with a wide range of abilities, and we provide an accessible candidate experience; accommodations during the application process are available upon request.